When to See a Doctor for Diabetes-Related Medical Issues

While you may not want to call your doctor for every small question, it’s important to remember that treatments for diabetes-related medical issues are more effective if you start them early.¹ 

Learning about and being aware of the various signs or symptoms of diabetes-related complications or other medical issues can help you know when you should contact your healthcare provider or seek immediate medical attention in the case of an emergency.² Here are a few examples and guidelines to keep in mind³:

• Changes in your daily health: If you feel lightheaded after standing, experience constipation, bloating, or nausea, have trouble with your vision—even just at night or when the light changes—or have sexual problems, these can all be signs of health issues related to your nerves.⁴
• Pain, numbness, weakness, or tingling—especially in the hands, feet, arms, or legs: these feelings might seem insignificant, but they can be a sign of early nerve damage. And if that's the case, your symptoms can worsen as nerves become more damaged.⁴
• Skin problems or infections: From wounds or cuts that won't heal to ongoing sinus, bladder, or vaginal infections, diabetes can interfere with your body's ability to recover on its own.⁵
• Illness: Being sick can affect your blood sugar levels,⁶ so if you're feeling feverish, are sweating or have the chills, experiencing nausea, vomiting, or diarrhea, your doctor will want to know to ensure that it’s not an infection that needs care.³ If you can't keep food or fluids down, call for emergency assistance.⁷
• High blood sugar: If your blood glucose levels remain above 240 mg/dL or 13.3 mmol/L, even after taking your medicine and/or increasing your insulin and fluid intake, or if you have trouble staying in range, make an appointment to see your doctor.⁷
• Moderate to large ketones in your urine: Talk to your doctor if you are experiencing symptoms that might signal ketoacidosis or dehydration, such as worsening abdominal pain, trouble breathing, or breath that smells fruity or like acetone.⁸

If you’re still not sure whether to contact your doctor, remember that they’ll want to be kept informed of any health-related issues.

Contacting your doctor or healthcare provider to talk about what you’re experiencing can help you understand if there's an issue that needs to be addressed.

After a discussion or examination, your doctor may be able to alleviate the symptoms you are experiencing and even help slow the progression of the problem through possible interventions, including better blood sugar control.

Even if you only visit your doctor for a short time, it’s important that your conversations are productive. Here are some suggestions on how to get the most out of your doctor’s appointment to discuss any diabetes complications you might be experiencing and learn more about managing diabetes.

1. Plan ahead. Send your numbers to your doctor in advance of your appointment by email, fax, or a diabetes management app like mySugr, depending on what their office prefers, and be sure to note anything that seems out of the ordinary to you. Also, bring a copy of everything you sent to your appointment, just in case. Your doctor might only be able to glance at the paperwork before you meet, but having that information on your file could help save time.
2. Collect your questions. Whether in a notepad or on your phone, having a list of questions to refer to—and take notes on—can help you cover everything you want to discuss and keep the important answers all in one place.
3. Be honest. Your doctor is there to help you navigate challenges and solve problems, so a straightforward approach to sharing your results and your current physical state can help them give you the best advice for your situation. If you’re hesitant or embarrassed, know that you’re not alone in dealing with that particular issue.
4. Participate in the decisions. While your doctor is a medical expert, you’re the expert on what works for you. You should feel comfortable sharing your ideas and suggestions at the appointment, as the best patient-doctor relationships are respectful and collaborative.
5. Know what’s feasible. It's okay to say that a particular goal feels too challenging. Your doctor would rather have you leave with instructions that you’ll definitely be able to follow than offer advice that leaves you feeling uncomfortable or overwhelmed.
6. Follow through. If you agree to reach for specific goals or make changes to your current routine, take the time and effort to give it your best try. And if you discover something that’s getting in your way, think about how to solve it. Is testing pain getting in the way of checking your blood sugar? Get a less painful lancing device or try alternate site testing.^9,10 Are you finding that you don’t have time to exercise? Take the stairs at work. Starting with the goal and then brainstorming various ways to achieve it can help you discover different approaches.
7. Create a sick day plan. For days when you feel under the weather, it can be helpful to have an action plan in place that you create in collaboration with your healthcare team.

If you are feeling ill due to complications from diabetes, focusing on your diabetes self-management can help you deal with what’s going on with your body.

Developing a sick day plan with your healthcare team ahead of time will make it easier to make decisions when you’re not feeling well. Be sure to ask them how often to check your blood glucose and ketones, what medicines to take, and what foods to eat, as well as when you should ask/call for help. 

What to do at the first sign of illness

Understanding how illness might affect your blood glucose can help you take the right steps to care for yourself when you’re not feeling well. For example:⁶

• Check your sugar levels more often. Since you might need more insulin to keep your glucose levels in check, do not stop taking insulin without first talking to your doctor. Even if you are having trouble eating, you will likely need extra insulin to combat the hormones that often cause high blood glucose during illness.¹¹ 
• If you have type 1 diabetes, monitor your blood glucose levels and urine ketones frequently, around every few hours or as often as your doctor recommends.
• Stay hydrated. Drink plenty of calorie-free, caffeine-free, clear liquids.
• Make sure you eat according to your regular meal plan. Keep easy-to-eat, fast-acting carbohydrates available, which can be useful in treating low blood sugar, and a meal substitute just in case. If you feel nauseated or are vomiting, try a sports drink, juice, regular soft drinks, or even frozen fruit bars to get the carbs you need.
• Talk to your diabetes care provider about any medications you take or any unexpected blood glucose results you experience while taking them. Some cold medicines, antibiotics, and other prescriptions and over-the-counter drugs could affect blood glucose levels.¹²

Successfully navigating an illness and knowing when to contact your doctor can feel overwhelming. Now that you have these useful guidelines and know how to prepare, you can work with your healthcare provider to help you make the best decisions for yourself.

¹ The Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group. Mortality in Type 1 Diabetes in the DCCT/EDIC Versus the General Population. Diabetes Care. 2016;39(8):1378-1383. doi:10.2337/dc15-2399

² Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. Global trends in diabetes complications: a review of current evidence. Diabetologia. 2019;62(1):3-16. doi:10.1007/s00125-018-4711-2

³ Diabetes when you’re unwell. Diabetes UK. Accessed February 1, 2024. https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/illness

⁴ Feldman EL, Callaghan BC, Pop-Busui R, et al. Diabetic neuropathy. Nat Rev Dis Primer. 2019;5(1):41. doi:10.1038/s41572-019-0092-1

⁵ Gupta S, Koirala J, Khardori R, Khardori N. Infections in Diabetes Mellitus and Hyperglycemia. Infect Dis Clin North Am. 2007;21(3):617-638. doi:10.1016/j.idc.2007.07.003

⁶ Wensveen FM, Šestan M, Turk Wensveen T, Polić B. Blood glucose regulation in context of infection. In: Vitamins and Hormones. Vol 117. Elsevier; 2021:253-318. doi:10.1016/bs.vh.2021.06.009

⁷ Mayo Clinic Staff. Hyperglycemia in diabetes-Hyperglycemia in diabetes - Symptoms & causes. Mayo Clinic. Accessed February 13, 2024. https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631

⁸ Dhatariya KK, Glaser NS, Codner E, Umpierrez GE. Diabetic ketoacidosis. Nat Rev Dis Primer. 2020;6(1):40. doi:10.1038/s41572-020-0165-1

⁹ Kocher S, Tshiananga JKT, Koubek R. Comparison of Lancing Devices for Self-Monitoring of Blood Glucose regarding Lancing Pain. J Diabetes Sci Technol. 2009;3(5):1136-1143. doi:10.1177/193229680900300517

¹⁰ Anitha Pavithran A, Ramamoorthy L, Bs S, Murugesan R, Mj K. Comparison of Fingertip vs Palm Site Sampling on Pain Perception, and Variation in Capillary Blood Glucose Level among Patients with Diabetes Mellitus. J Caring Sci. 2020;9(4):182-187. doi:10.34172/jcs.2020.028

¹¹ Brealey D, Singer M. Hyperglycemia in Critical Illness: A Review. J Diabetes Sci Technol. 2009;3(6):1250-1260. doi:10.1177/193229680900300604

¹² Kennedy KE, Teng C, Patek TM, Frei CR. Hypoglycemia Associated with Antibiotics Alone and in Combination with Sulfonylureas and Meglitinides: An Epidemiologic Surveillance Study of the FDA Adverse Event Reporting System (FAERS). Drug Saf. 2020;43(4):363-369. doi:10.1007/s40264-019-00901-7

¹American Diabetes Association. When you're sick. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/whos-on-.... Accessed April 30, 2016.

²EndocrineWeb. Diabetic neuropathy symptoms. Available at: https://www.endocrineweb.com/guides/diabetic-neuropathy/diabetic-neuropa.... Accessed February 15, 2017.

³WebMD. Diabetes and infection: how to spot the signs. Available at: http://www.webmd.com/diabetes/guide/infections-linked-diabetes. Accessed February 15, 2017.

⁴Mayo Clinic. Hyperglycemia in diabetes. Available at: http://www.mayoclinic.org/diseases-conditions/hyperglycemia/basics/sympt.... Accessed February 15, 2017.